Frequency Of Sessions Research Articles

Comparison of the immediate effects of plantar vibration of both feet with the plantar vibration of the affected foot on balance in patients with stroke: Preliminary findings

ObjectivePlantar vibration is one of the strategies to enhance balance in stroke patients. This study compared the effects of the plantar vibration of both feet and the plantar vibration of the most affected side in patients with stroke. MethodsThis study was a single-blind clinical trial. Post-stroke patients with balance impairment were enrolled in the study and underwent two treatment sessions with a one-week interval. They received both feet's plantar vibration in one session and plantar vibration of the most affected side in the other session (frequency 100 Hz, 5 min). Mini-BESTest, Modified Modified Ashworth Scale (MMAS), and Semmes-Weinstein monofilament examination (SWME) were used to evaluate balance, spasticity, and plantar sensation, before and after the treatment sessions. ResultsTen patients with a mean age of 52.9 (SD = 5.48) years were enrolled in the study. Mini-BESTest scores of balance and plantar flexor muscle spasticity were significantly improved after both feet plantar vibration and plantar vibration of the more affected side. There was no significant difference between the effectiveness of both sides plantar vibration and the most affected side plantar vibration. There were no significant improvements in SWME sensory scores after plantar vibration of either both sides or the most affected side. ConclusionPlantar vibration of both sides had no additional benefits in this group of patients with chronic stroke. Plantar vibration of more affected side can be used for improving balance and plantar flexor spasticity post-stroke. The Plantar vibration had no effects on the affected foot sensibility.

Jumping Rope Improves the Physical Fitness of Preadolescents Aged 10-12 Years: A Meta-Analysis.

To systematically review the effects of jumping rope on physical fitness among 10 to 12-year-old preadolescents, and to provide evidence-based support for its use in school physical education curriculum work. The PubMed, Web of Science, SPORTDiscus, ScienceDirect, and CNKI databases were searched for randomized controlled trials that assessed jumping rope and physical fitness among preadolescents aged 10-12 years. Meta-analyses were used to calculate the standardized mean difference (SMD) values and 95% confidence intervals (CI), and subgroup analyses were conducted on intervention duration, frequency and period. A total of 1048 subjects from 15 studies were included. Compared to regular physical education courses, jumping rope did not show a significant advantage in terms of body morphology. In terms of physical function, boys showed greater improvements in vital capacity, and girls showed greater improvements in resting HR. In terms of physical performance, boys showed greater improvements in speed, upper-body strength, lower-body strength, muscular endurance and agility, while girls showed greater improvements in coordination and balance. Boys experienced a minimal improvement in flexibility, while girls did not show a significant difference. Combining the results of the subgroup analyses, the optimal session time, frequency and intervention length of jumping rope for significantly improving the physical fitness of preadolescents were >40 min, 2 times/week and 8-12 weeks, respectively. In conclusion, jumping rope provides small to large benefits over regular physical education for both boys and girls aged 10-12 years in terms of physical function and physical performance indicators other than flexibility, while showing no significant advantage in terms of body morphology. Based on the available research, it is recommended that children aged 10-12 years participate in jump rope sessions for at least 40 minutes once or twice a week for 8-12 weeks to better develop physical fitness.

Physical and mental morbidity pattern among female cashew workers in Kollam district, Kerala

Background: The cashew processing is a labour-intensive work with a significant number of female workers. Majority belong to low socioeconomic status and so they join this sector to meet up their daily living. Long hours of work, greater work load and increased family burden lead to increase in morbidity status among workers. As comorbidities gets unnoticed and ignored, there is occurrence of early morbidity as well as mortality in these working groups and this is one of the major concerns. Methods: Cross-sectional study was conducted among female cashew workers in Kollam district, Kerala. Data was collected using interviewer administered questionnaire using stratified multistage cluster sampling method. Seven workers each were selected from shelling, peeling and grading processing units from eight private and two government factories. Data entered in micrososft excel, coded and analyzed using SPSS software version 25. Descriptive statistics for qualitative data were expressed as frequency and percentages and quantitative data as mean and standard deviation Results: Out of 210 participants, 95.4% workers were suffering from one or the other morbidities. Arthralgia was the major concern followed by allergy, hypertension and thyroid. Prehypertensive state was found to be present among all participants. Anxiety noticed in majority of participants. Conclusions: Frequent medical check-ups, recreational activities and health education sessions needs to be implemented in all cashew factories to lessen the morbidity and to up bring the health status of workers.

Electroencephalographic interbrain synchronization in children with disabilities, their parents, and neurologic music therapists.

As with typically developing children, children with cerebral palsy and autism spectrum disorder develop important socio-emotional rapport with their parents and healthcare providers. However, the neural mechanisms underlying these relationships have been less studied. By simultaneously measuring the brain activity of multiple individuals, interbrain synchronization could serve as a neurophysiological marker of social-emotional responses. Music evokes emotional and physiological responses and enhances social cohesion. These characteristics of music have fostered its deployment as a therapeutic medium in clinical settings. Therefore, this study investigated two aspects of interbrain synchronization, namely, its phase and directionality, in child-parent (CP) and child-therapist (CT) dyads during music and storytelling sessions (as a comparison). A total of 17 participants (seven cerebral palsy or autism spectrum disorder children [aged 12-18 years], their parents, and three neurologic music therapists) completed this study, comprising seven CP and seven CT dyads. Each music therapist worked with two or three children. We found that session type, dyadic relationship, frequency band, and brain region were significantly related to the degree of interbrain synchronization and its directionality. Particularly, music sessions and CP dyads were associated with higher interbrain synchronization and stronger directionality. Delta (.5-4Hz) range showed the highest phase locking value in both CP and CT dyads in frontal brain regions. It appears that synchronization is directed predominantly from parent to child, that is, parents and music therapists' brain activity tended to influence a child's. Our findings encourage further research into neural synchrony in children with disabilities, especially in musical contexts, and its implications for social and emotional development.

Descriptions of sham acupuncture in randomised controlled trials: a critical review of the literature

BackgroundSham acupuncture is usually used to assess the specific effects of acupuncture. However, the reporting quality of sham acupuncture remains unclear despite its critical importance in understanding and analyzing the effects of acupuncture. This paper presents a literature review aimed at assessing the quality of reporting of sham acupuncture in randomized controlled trials (RCTs) based on STRICTA 2010 and TIDieR-Placebo.MethodsThree electronic English-language databases (PubMed, MEDLINE and Embase) were searched from inception to March 7, 2022, and RCTs of sham acupuncture were identified. The reporting quality of sham acupuncture was assessed in accordance with the items recommended in STRICTA 2010 and TIDieR-Placebo. The reporting quality of other items related to sham acupuncture apart from items from these two checklists was also captured to further assess the reporting quality of sham acupuncture.ResultsA total of 609 eligible studies were included. For all of the items recommended in STRICTA 2010 and TIDieR-Placebo, 100% of the studies reported a brief name that described the sham acupuncture, 93.9% studies reported the needle type, and 90.0% reported the names of the points used. Other items for which the reporting rates were above 50% included the number, frequency and duration of treatment sessions; needle retention time; and number of needle insertions per subject per session. Overall, 49.4% of the studies revealed the rationale why sham acupuncture was chosen, 39.7% of the studies involving insertion processes reported the depth of insertion, and 37.9% of the studies reported the needle manufacturer. Other items for which the reporting rates were below 30% included practitioner-related information, response sought, evaluation of blinding, intervention mode and environment, assisting tools, and the extent to which the treatment was varied. The items “Modifications”, “How well (planned)” and “How well (actual)” were not reported in any of the analyzed studies.ConclusionsThe overall reporting quality of sham acupuncture in RCTs was suboptimal. Although STRICTA 2010 and TIDieR-Placebo could be beneficial for describing sham acupuncture, neither can offer recommendations specifically for sham acupuncture. There is thus an urgent need to develop specialized guidelines for reporting sham acupuncture in clinical trials.

Dose frequency randomized controlled trial for Dynamic Temporal and Tactile Cueing (DTTC) treatment for childhood apraxia of speech: protocol paper

BackgroundChildhood apraxia of speech (CAS) is a pediatric motor-based speech sound disorder that requires a specialized approach to intervention. The extant literature on the treatment of CAS commonly recommends intensive treatment using a motor-based approach, with some of the best evidence supporting the use of Dynamic Temporal and Tactile Cueing (DTTC). To date, a rigorous and systematic comparison of high and low dose frequency (i.e., frequency of therapy sessions) has not been undertaken for DTTC, resulting in a lack of evidence to guide decisions about the optimal treatment schedule for this intervention. The current study aims to fill this gap in knowledge by comparing treatment outcomes when dose frequency is varied.MethodsA randomized controlled trial will be conducted to examine the efficacy of low versus high dose frequency on DTTC treatment outcomes in children with CAS. A target of 60 children, 2;6–7;11 years of age, will be recruited to participate in this study. Treatment will be provided in the community setting by speech-language pathologists who have completed specialized training administering DTTC in a research reliable manner. True randomization with concealed allocation will be used to assign children to either the low or high dose frequency group. Treatment will be administered in 1-h sessions either 4 times per week over a 6-week period (high dose) or 2 times per week over a 12-week period (low dose). To measure treatment gains, probe data will be collected before treatment, during treatment, and 1 day, 1 week, 4 weeks, and 12 weeks post-treatment. Probe data will consist of customized treated words and a standard set of untreated words to assess generalization of treatment gains. The primary outcome variable will be whole word accuracy, encompassing segmental, phonotactic, and suprasegmental accuracy.DiscussionThis will be the first randomized controlled trial to evaluate dose frequency for DTTC treatment in children with CAS.Trial registrationClinicalTrials.gov identifier NCT05675306, January 6, 2023.

НАПРЯМИ ПІДВИЩЕННЯ ЕФЕКТИВНОСТІ СИСТЕМИ НАВЧАННЯ ТА РОЗВИТКУ ПЕРСОНАЛУ НА ПІДПРИЄМСТВІ АТ «УКРТРАНСГАЗ» СТРИЙСЬКЕ ВУПЗГ

The article analyzes the directions for enhancing the effectiveness of the training and personnel development system at the Ukrtransgaz JSC Stryi production management of underground gas storage. To better understand the needs and expectations of employees regarding personnel development and training, a survey of the company's managerial staff was conducted. Based on the respondents' answers, the following alternatives for training and personnel development were proposed: increasing the frequency of training sessions, incorporating more examples of real-life events, implementing international training programs and knowledge exchange with EU countries, conducting off-site training programs and involving external instructors, expanding the range of training activities, and organizing educational events. The research emphasizes the importance of training and personnel development for the successful functioning of the organization. They are identified as key elements of strategic human resource management, contributing to enhancing employee competence and supporting continuous professional growth. Improving the training and personnel development system is one of the crucial components of any enterprise's success. In today's rapidly changing world, where competition is becoming increasingly fierce and technologies are advancing every day, it is important to have a team of specialists who constantly update their knowledge and skills. The competitiveness of the enterprise and its ability to adapt to new challenges and innovations depend on this. The enterprise should undoubtedly be responsible for the training of its personnel and implement only those training forms that fully consider the needs of the workplace and individual characteristics of the staff. Additionally, it is necessary to provide motivation for employees undergoing training, so that they are interested in its successful completion and understand the benefits they will gain as a result. The enterprise should also ensure suitable conditions for training, such as adequate facilities and equipment. Furthermore, the information provided during the training process should be structured and sequential, starting from foundational stages to more complex concepts. The training process should incorporate feedback on the training outcomes, which will contribute to the further development and improvement of the personnel. Training and development tools and methods help organizations prepare their employees for new challenges, develop their potential, and ensure their ability to perform effectively. A well-structured system of training and personnel development can have a positive impact on the organization's growth, enhancing its competitiveness in the market and increasing profitability. By investing in training and development initiatives, organizations can enhance employee skills, knowledge, and abilities, enabling them to adapt to changing industry trends and technological advancements. This helps organizations stay competitive and meet the evolving needs of their customers. Various tools and methods can be utilized in training and development programs, such as workshops, seminars, online courses, mentoring, coaching, job rotations, and on-the-job training. These approaches provide employees with opportunities to acquire new knowledge, improve their job-related skills, and develop a broader understanding of the organization's goals and strategies.

(035) Feasibility and Acceptability of a Virtual Group Mindfulness-based Therapy for Women with Lifelong Anorgasmia: A Pilot Study

Abstract Introduction For a woman to experience an orgasm she needs adequate physical, psychological, social and emotional stimulation to be highly aroused and have the ability to let go and be vulnerable. Mindfulness positively impacts attentional control, cognitive control, emotion regulation, and how one processes the perception of one’s self. Research indicates the positive influence of mindfulness training on immune function and overall brain function1, positively influencing outcomes including improved levels of performance on attentional tasks2, increased empathy3, and reduced physical symptoms and stress4, as well as positive changes in anxiety and depression.5 Group-based mindfulness cognitive behavioral therapy in women with sexual interest and arousal disorder have shown an improvement in sexual desire, distress, and function measures.6-8 Objective We expect that we will be able to recruit, enroll and retain females living with anorgasmia into a virtual, group-based mindfulness intervention. Methods Subjects were recruited using social media and flyers for self-referral and physician-referral methods. The study enrolled 10 females with self-reported lifelong anorgasmia with an average age of 39 years (±10.4), 90% white, 10% black. All subjects reported being non-Hispanic or Latina, identified as straight, and in monogamous relationships. Menopause status varied among subjects. We conducted an 8-week virtual, group mindfulness series incorporating mindfulness education, writing exercises, opportunities for meditation practice, with time for discussion and sharing. Subjects received daily reminders to listen to prescribed mindfulness meditations at home. Meditation usage was tracked using REDCap including which recording was listened to, session duration, and session frequency. Results Of 26 women screened, 10 enrolled in the study. Two had scheduling conflicts, 2 never attended a session, and 6 attended at least four sessions. Of these, the average attendance was 75% during each session and each subject attending an average of 6 sessions. Subjects were asked to rate (0-10, where “0” is Not at all Appropriate and “10” is Very Appropriate) the degree to which group and virtual formats were appropriate (8.33 ±1.89, 8.17±2.62), and the weekly meeting schedule (7.33 ±2.56). At-home recording platform was deemed easy to use (8.83 ±1.67), however, subjects felt the recordings were moderately beneficial and convenient (6.33 ±1.11 and 5.17 ±1.86). Mindfulness meditations were listened to 173 times, with a subject mean of 28.8 (±20.7) times. When session duration was adjusted for excessive time, the mean mindfulness duration was 15.5 (±9.2) minutes. With a sample of only 8 subjects, we cautioned against reporting any pre-to-post analyses for the Female Sexual Function Index, the Five Facet Mindfulness Questionnaire, Perceived Stress Scale-10, PROMIS-Sexual Function, PROMIS-Depression SF or PROMIS-Anxiety SF. Completion rates at both the pre- and post- time points was 75%. Conclusions The virtual group-based mindfulness intervention was generally perceived to be appropriate and easy to use for females presenting with anorgasmia and enabled participation from all over the US. With this success, future research with a larger sample size and a comparison group are warranted. Disclosure No.

Group music therapy with songwriting for adult patients with long-term depression (SYNCHRONY study): a feasibility and acceptability study of the intervention and parallel randomised controlled trial design with wait-list control and nested process evaluation

BackgroundDespite effective treatments, one fifth of patients develop chronic depression. Music therapy may offer a different approach. This study aimed to assess feasibility and acceptability of a music therapy intervention and trial methodology.MethodsA parallel two-arm randomised controlled trial with wait-list control, mixed feasibility/acceptability measures and nested process evaluation. Adults with long-term depression (symptom duration > 1 year) were recruited from community mental health services and computer randomised to 42 sessions of group music therapy with songwriting three times per week or wait-list control. Depression, social functioning, distress, quality of life, satisfaction and service use were assessed by blinded researchers at enrolment, 1 week and 3 and 6 months post-therapy. Outcomes were analysed descriptively, controlling for baseline covariates. Recruitment (number eligible, participation and retention rates) and intervention (fidelity, adherence) feasibility were assessed using pre-defined stop–go criteria. Attendance, adverse events, mood, relationship satisfaction and semi-structured interviews were analysed in a nested process evaluation.ResultsRecruitment processes were feasible with 421 eligible, 12.7% participation and 60% (18/30) retention. Thirty participants were randomised to intervention (N = 20) and control (N = 10). Session attendance was low (mean 10.5) with four withdrawals. Music therapist adherence was good but changes to session frequency were suggested. Outcomes were available for 10/20 treatment and 9/10 wait-list participants. Depression increased in both arms post-therapy. Treatment depression scores fell below baseline 3 and 6 months post-therapy indicating improvement. Wait-list depression scores increased from baseline 3 and 6 months post-therapy. At 3 months, the treatment arm improved from baseline on all measures except satisfaction and functioning. At 6 months, quality of life, distress and functioning improved with reduction in health service contacts. High-attending participants improved more than low-attending. Seven adverse events (one serious) were reported.LimitationsAs this was a feasibility study, clinical outcomes should be interpreted cautiously.ConclusionA randomised controlled trial of group music therapy using songwriting is feasible with inclusion criteria and session frequency modifications, but further intervention development is required.Trial registrationISRCTN18164037 on 26.09.2016.

USING THE THEORY OF PLANNED BEHAVIOR TO UNDERSTAND PADDY RICE FARMERS' INTENTION TO PARTICIPATE IN WAREHOUSE RECEIPT SYSTEM

The Warehouse Receipt System (WRS) is one of the tools available for farmers to combat commodity price instability that often happens during harvest season. The WRS Program, complemented by the WRS Subsidy Scheme, has already been implemented in Indonesia for almost fourteen years with minimum participation from the farmers. This research uses a model based on the Theory of Planned Behavior to understand factors affecting the intention level of paddy rice farmers in Demak to participate in the WRS Program. This research employs a quantitative approach, collecting data using surveys to sample farmers from Demak and Dempet Subdistricts and analyzing it using descriptive analysis and SEM-PLS. This research found a small yet positive intention of paddy rice farmers in Demak to participate in the WRS Program. All direct and indirect determinants of intention based on the TPB positively affect farmers' intention to participate in the WRS Program. This research also suggests improving farmers' intention to participate in the WRS Program. The government is advised to build more facilities in the WRS Program warehouse to make it easier for farmers to store their commodities in the WRS warehouses, increasing their perceived behavioral control. The government needs to focus on and increase the frequency of information-sharing sessions regarding the WRS Program to improve farmers' attitudes, subjective norms, and perceived behavioral control. The government can also explore other policy instruments besides the WRS Subsidy Scheme, such as the Nudge to improve farmers' participation In the WRS Program.

Designing an eSports intervention for middle-aged and older adults in Hong Kong: Social marketing approach.

This study examined the perceptions and experiences of middle-aged and older adult participants in electronic sports (eSports) in Hong Kong (HK), China, by using the social marketing (SM) approach. This qualitative study applied SM approach to the design of a center-based eSports intervention for middle-aged and older adults in HK. Interviews were conducted with 39 adults stratified in terms of age (i.e., 45-64 vs. ≥65 years) and experience with eSports. Ten administrators working in community elderly centers were invited for semistructured interviews. Thematic analysis was performed on the data by incorporating SM. Main findings are presented in terms of five P's. The product component of an eSports intervention includes the foundation of eSports (e.g., safety, eSports training), suitable games for older adults, and professional equipment (e.g., large-screen devices and motion-controlled Nintendo Switches). The price component comprises affordability and the frequency and duration of each eSport session, and the place component includes accessibility and spaces to play eSports. The promotion component should be educational in nature and can incorporate free trials and gaming days, short films about older adults playing eSports, promotional channels, physical evidence and annual eSports competitions. The people component consists of support from administrators and the center in charge, the availability of skilled program instructors and staff, and appropriate partnering, team sizes and instructor-to-participant ratios. The 5P's enhance the design of future center-based eSports interventions and can help researchers and practitioners determine which aspects encourage middle-aged and older adults to participate in eSports.

Aerobic and resistance exercise in heart failure inpatients: a scoping review.

Exercise performance is an essential tool for managing heart failure. Although the benefits of exercise are well documented for people with chronic and stable heart failure, there is still no consensus on their prescription in patients hospitalized with acute heart failure undergoing clinical stabilization. The aim of this study is to identify the literature on exercise programs encompassing the components of aerobic and resistance training for hospitalized patients admitted for acute heart failure. A scoping review was conducted according to the proposed methodology of the Joanna Briggs Institute. Studies with adults over 18years old, hospitalized, and diagnosed with acute heart failure who participated in aerobic and resistance exercise training programs during their hospital stay were included. Three studies met the inclusion criteria. One was a retrospective, observational analytical cohort study, in which the main outcome of the exercise program was improvement in the previous disabilities of the participants. The other two were multicenter randomized controlled studies that showed greater improvement in physical function, functional capacity, depression, quality of life, and frailty status in the intervention groups. The exercise prescriptions differed according to the principles of the exercise prescription-frequency of exercise, intensity of exercise, exercise time (duration), type (mode), exercise volume, and progression. It is too early to make recommendations based on evidence of the type structure of an exercise program with aerobic and strength-training components in this population. However, in the exercise programs of the reviewed studies, the predominance of light to moderate intensity and the importance of progressively increase the frequency and duration of the training sessions were demonstrated, with bicycle ergometers and walking being the most common types of aerobic exercises. It is recommended that investment and research in this area should continue with more methodologically robust studies.

Effects of aerobic exercise on metabolic indicators and physical performance in adult NAFLD patients: A systematic review and network meta-analysis.

nonalcoholic fatty liver disease (NAFLD) is characterized by excessive accumulation of fat in the liver without alcoholism. We conducted a systematic review and meta-analysis to elucidate the efficacy of aerobic exercise on metabolic indicators and physical performance of adult patients with NAFLD. To conduct the systematic review and network meta-analysis, 2 researchers searched PubMed, EBSCO, and Web of science databases to identify randomized clinical trials of aerobic exercise interventions for adults with NAFLD published between inception and July 2022. We assessed the methodological quality of the included literature using the Cochrane Risk Assessment Scale and the PEDro Scale. Relevant data were extracted, variables were converted to the same units, and meta-analysis was performed using RevMan 5.4 software. We compared mean differences (MD) between experimental and control groups. For each outcome analyzed, we expressed data as MD with 95% CI to compare metabolic markers and exercise capacity between the experimental and control NAFLD patients. Eleven randomized clinical trials with a total of 491 individuals with NAFLD were included in accordance with the criteria of this study. Types of aerobic exercise include moderate or high-intensity interval running, cycling, Nordic walking, equipment training, etc; Training duration 4 to 16 weeks, 30 to 60 minutes 3 or more times a week. Compared with the control group, aerobic exercise group had reduced weight of patients, (MD) 1.20 kg (95% CI: -1.38 to -1.01 kg, P < .00001). Seven studies confirmed that aerobic exercise significantly reduced triglycerides, (MD) 3.00 mg/dL (95% CI: -5.80 to -0.21 mg/dL, P = .04); increased high density lipoproteins (MD) 5.96 mg/dL (95% CI: 2.95 to 8.96 mg/dL, P = .0001) and reduced low-density lipoproteins (MD) 6.45 mg/dL (95% CI: -8.53 to -4.37 mg/dL, P < .00001); the study also showed that aerobic exercise reduced the liver enzymes aspartate aminotransferase and alanine aminotransferase to varying degrees. Aerobic exercise can improve physical performance and increase peak oxygen consumption of (MD) 6.29 mL/Kg*minutes, (95% CI: 3.05-9.53mL/Kg*minutes, P = .0001). Aerobic exercise significantly reduced weight and improved metabolic index and physical performance. Impacted by the limitations of various regimens, doses, duration, center settings, populations enrolled, the study had certain limitations. The randomized controlled trials with larger sample sizes, multiple centers, and high quality should be conducted to validate the above conclusion. Further studies will be required to focus on the total duration of the intervention, duration and frequency of sessions, and intensity that are optimal for the promotion of physical performance and metabolic capacity in this population.

Acceptability of a progressive resistance training programme for ambulatory adolescents with spastic cerebral palsy in England: a qualitative study

Purpose The aim of this study was to explore the acceptability of a 10-week progressive resistance training programme from the perspective of ambulatory adolescents with CP and physiotherapists. Material and Methods Semi-structured interviews were conducted with 32 adolescents with spastic CP, aged 10–19 years in Gross Motor Function Classification System (GMFCS) levels I–III, and 13 physiotherapists. Adolescents had completed a 10-week progressive resistance training programme and physiotherapists had delivered the programme. The Framework Method was used to analyse data. Results The analysis identified four themes. “It’s do-able” described the acceptability of the programme structure, including the frequency of sessions and the duration of the programme. “They were difficult but I did it” described the acceptability of the exercises. “It is completely different,” explored the experience of using equipment to progress the programme and “I wish I could do it on a permanent basis” discussed continuing to participate in resistance training. Conclusions Findings suggest that resistance training is largely acceptable to adolescents and physiotherapists. Acceptability was enhanced by having a weekly supervised session and being able to adapt and progress the exercises to meet the individual’s ability. However, there are challenges to implementing progressive resistance training as part of routine practice.Clinical trial registration number: ISRCTN90378161

Individual psychotherapy for cluster-C personality disorders: protocol of a pragmatic RCT comparing short-term psychodynamic supportive psychotherapy, affect phobia therapy and schema therapy (I-FORCE)

BackgroundCluster-C personality disorders (PDs) are highly prevalent in clinical practice and are associated with unfavourable outcome and chronicity of all common mental health disorders (e.g. depression and anxiety disorders). Although several forms of individual psychotherapy are commonly offered in clinical practice for this population, evidence for differential effectiveness of different forms of psychotherapy is lacking. Also, very little is known about the underlying working mechanisms of these psychotherapies. Finding evidence on the differential (cost)-effectiveness for this group of patients and the working mechanisms of change is important to improve the quality of care for this vulnerable group of patients.ObjectiveIn this study, we will compare the differential (cost)-effectiveness of three individual psychotherapies: short-term psychodynamic supportive psychotherapy (SPSP), affect phobia therapy (APT) and schema therapy (ST). Although these psychotherapies are commonly used in clinical practice, evidence for the Cluster-C PDs is limited. Additionally, we will investigate predictive factors, non-specific and therapy-specific mediators.MethodsThis is a mono-centre randomized clinical trial with three parallel groups: (1) SPSP, (2) APT, (3) ST. Randomization on patient level will be pre-stratified according to type of PD. The total study population to be included consists of 264 patients with Cluster-C PDs or other specified PD with mainly Cluster-C traits, aged 18–65 years, seeking treatment at NPI, a Dutch mental health care institute specialized in PDs. SPSP, APT and ST (50 sessions per treatment) are offered twice a week in sessions of 50 min for the first 4 to 5 months. After that, session frequency decreases to once a week. All treatments have a maximum duration of 1 year. Change in the severity of the PD (ADP-IV) will be the primary outcome measure. Secondary outcome measures are personality functioning, psychiatric symptoms and quality of life. Several potential mediators, predictors and moderators of outcome are also assessed. The effectiveness study is complemented with a cost-effectiveness/utility study, using both clinical effects and quality-adjusted life-years, and primarily based on a societal approach. Assessments will take place at baseline, start of treatment and at 1, 3, 6, 9, 12, 18, 24 and 36 months.DiscussionThis is the first study comparing psychodynamic treatment to schema therapy for Cluster-C PDs. The naturalistic design enhances the clinical validity of the outcome. A limitation is the lack of a control group for ethical reasons.Trial registrationNL72823.029.20 [Registry ID: CCMO]. Registered on 31 August 2020. First participant included on 23 October 2020.

Are psychological interventions for adult PTSD more efficacious and acceptable when treatment is delivered in higher frequency? A meta-analysis of randomized controlled trials.

Two systematic reviews indicated that higher treatment frequency of psychological interventions for adult PTSD may lead to higher efficacy and less dropout. Yet, a quantitative review is missing. We conducted a thorough systematic literature search and included trials meeting the following criteria: a) random allocation, 2) PTSD was primary treatment focus, 3) ≥70% interview-based PTSD rate 4) mean age ≥18 years, and 5) N≥20. Treatment session frequency was analyzed dichotomously (< 1.5 vs. ≥ 1.5 sessions/week) and continuously (sessions per week & minutes per week). A total of 160 RCTs with data from 10,556 patients were included. Analyses yielded similar treatment efficacy irrespective of treatment frequency definitions and whether differential efficacy was estimated directly via head-to-head trials or indirectly via comparisons to the same comparison group. Intense (≥ 1.5 sessions/week) vs. standard (< 1.5 sessions/week) delivery was, however, associated with significantly lower dropout rates (as a proxy for acceptability) for trauma-focused interventions (18.64% vs 11.54%, respectively, p=.024), but not for non-trauma-focused interventions. We found no evidence for differential treatment efficacy of intense vs. standard psychotherapies for adult PTSD. Evidence for increased acceptability was found for intense vs. standard trauma-focused interventions.

Ötetanısal (Transdiyagnostik) Bilişsel Davranışçı Psikoterapi: Bütünleşik Protokol Örneği

The fact that there are many limitations of the current classification systems led to the emergence of transdiagnostic approaches (TA) that focus on the common psychopathological processes underlying disorders rather than categorical diagnoses. TA focuses on the underlying common psychopathological processes in the emergence and persistence of mental disorders. Thus, even if the disorders are categorically diagnosed differently, it can be determined how they overlap or separate with each other. TA aims to treat mental disorders using these aspects. TA has a flexible and modular structure that can be easily integrated into cognitive behavioral therapies. The rest of this review will focus on the Unified Protocol (UP), one of the most popular TA examples. The main purpose of the UP is to enable patients to recognize their feelings and give more adaptive reactions to their negative emotions. Accordingly, UP consists of eight modules. The modules can usually be completed in a total of 11 - 17 weeks. Each 50 to 60-minute individual session is held once a week. If necessary, changes can be made to the number or the frequency of sessions allocated to modules. The goals of each module of the UP and the treatment approaches towards these goals allow a very clearly defined approach. For this reason, there is a need for a detailed evaluation, conceptualization and treatment plan before the UP is put into practice. We hope that mental health professionals from Turkey will contribute to the developments in the UP.

Clinical practice guidelines on physical activity and exercise for pregnant women with gestational diabetes mellitus: A systematic review

This review aimed to appraise clinical guidelines about exercise for women with gestational diabetes mellitus and summarize consensus and inconsistent recommendations. Exercise is an effective non-pharmacological therapeutic for gestational diabetes mellitus, but the variety of relevant clinical practice guidelines is confusing for healthcare professionals. This is a systematic review of clinical practice guidelines. Websites of guideline development institutions, eight literature databases and organizations of obstetricians, gynaecologists, midwives, and medical sports associations were searched forguidelinespublishedfrom January 2011 to October 2021. Two reviewers independently extracted recommendations. Four reviewers assessed guideline quality using the AGREE II instrument independently. Fifteen guidelines were included. All women with diabetes are recommended to exercise during pregnancy. The consistent recommendations were for pre-exercise screening, for 30 min per exercise session on 5 days of the week or every day after meals, exercise at moderate intensity, using aerobic and resistance exercise, and walking. The main non-consistent recommendations included warning signs for women on insulin during exercise, minimum duration per session, intensity assessment, duration and frequency of sessions for strengthening and flexibility exercise and detailed physical activity giving birth. Guidelines strongly support pregnant women with diabetes to exercise regularly. Research is needed to make non-consistent recommendations clear.

Evaluation of the report quality of Chinese and English randomized controlled trials of acupuncture based on CONSORT statement and STRICTA checklist

To evaluate the report quality of Chinese and English randomized controlled trials (RCTs) of acupuncture based on the CONSORT statement and STRICTA checklist. The Chinese and English RCTs of acupuncture published from January 1, 2015 to December 31, 2019 were searched in 7 databases including PubMed. The report quality of the included RCTs was evaluated with the CONSORT 2010 statement and STRICTA checklist. A total of 506 Chinese RCTs and 76 English RCTs were included. According to the CONSORT statement, in Chinese RCTs, the items with report rate less than 50% accounted for 78.38% of all items, and the report rate of 25 items, such as background and reason, study design, outcome index, and sample size, was less than 10%. In English RCTs, the items with report rate less than 50% accounted for 35.14% of all items, and 5 items had a report rate of less than 10%. The difference of the report rate of 15 items, such as background, reason and study design, was more than 50% between Chinese and English RCTs. The report rate of all items of STRICTA checklist was relatively high in both Chinese and English RCTs. In Chinese RCTs, the items with report rate less than 50% accounted for 29.41% of all items, which included acupuncture rationale and depth of insertion. In English RCTs, only two items had a report rate less than 50%, which were acupuncture rationale, setting and context of treatment. The report rate of five items, including needle retention time, frequency and duration of treatment sessions, details of other interventions administered to the acupuncture group, setting and context of treatment, and precise description of the control or comparator in Chinese RCTs, were higher than in English RCTs. The report quality of Chinese acupuncture RCT needs to be improved urgently, and corresponding measures should be taken to further standardize the writing and reporting of acupuncture clinical research.

Treatment patterns, healthcare utilization, and costs of patients with treatment-resistant depression initiated on esketamine intranasal spray and covered by US commercial health plans

AimsTo describe real-world use of esketamine (ESK) intranasal spray and healthcare outcomes among patients with treatment-resistant depression (TRD) in the United States (US).MethodsAdults with TRD initiated on ESK (index date) between 5 March 2019 (US approval date for TRD) and 31 October 2020 were sampled from IBM MarketScan Research Databases. TRD was defined as claims for ≥2 unique antidepressants during the same major depressive episode. Subgroups of the TRD cohort with comorbid cardiometabolic conditions, pain, anxiety disorder, and substance use disorder (SUD) were identified. Patients had ≥6 months of continuous health plan eligibility pre- and post-index.ResultsThe TRD cohort comprised 269 patients; comorbidity subgroups included 123 (cardiometabolic), 144 (pain), 189 (anxiety disorder), and 58 (SUD) patients. Proportion of patients completing ≥8 ESK sessions (number of sessions in induction phase) was 61.3% in the TRD cohort and ranged from 60.2% (cardiometabolic subgroup) to 72.4% (SUD subgroup) in subgroups. Median frequency of induction sessions was every 5–8 days among the TRD cohort and subgroups. Mean mental health–related inpatient costs reduced from pre- to post-index periods in the TRD cohort (mean ± standard deviation [median] costs per-patient-per-6-months: $3,480 ± $13,328 [$0] pre-ESK initiation; $3,262 ± $16,666 [$0] post-ESK initiation; mean difference: –$218) and subgroups (largest decrease in cardiometabolic subgroup: $4,864 ± $14,271 [$0]; $2,792 ± $15,757 [$0]; –$2,072). Mean mental health–related emergency department (ED) costs decreased in the TRD cohort ($608 ± $2,525 [$0]; $269 ± $1,143 [$0]; –$339) and subgroups (largest decrease in the SUD subgroup: $1,403 ± $3,752 [$0]; $351 ± $868 [$0]; –$1,052).LimitationsThis is a descriptive analysis; sample size for some comorbidity subgroups is small.ConclusionsThe majority of patients completed ESK induction phase, and most dosing intervals were longer than the label recommendation. In this descriptive analysis, mental health–related inpatient and ED costs trended lower post-ESK initiation.